LAND USE APPLICATION - DIRECTOR Measure 49 Forest Zone Dwelling

LAND MANAGEMENT DIVISION Date Received: LAND USE APPLICATION - DIRECTOR Measure 49 Forest Zone Dwelling PUBLIC WORKS DEPARTMENT 3050 N. DELTA HWY, EUGENE OR 97408 Planning: 682-3577 For Office Use Only: FILE # FEE:* *No fee if submitted with an M49 Preliminary Partition Application Applicant (print name): Mailing address: Phone: Email: Applicant Signature: Agent (print name): Mailing address: Phone: Email: Agent Signature: Claimant (print name): Mailing address: Phone: Email: Claimant Signature: Land Owner (print name): Mailing address: Phone: Email: Land Owner Signature: PROPOSAL: A request for Director Approval of a Measure 49 dwelling in the Impacted Forest Lands (F-2) or Non-impacted Forest Lands (F-1) Zone pursuant to the siting criteria of Lane Code 16.211(8). LOCATION: Township Range Section Taxlot Site address Version 1/2013

REQUIRED SUBMITTALS (1) (2) (3) (4) (5) Completed Measure 49 Farm or Forest Zone Dwelling application form addressing siting criteria Site Plan. Refer to the handout entitled How to prepare your plot plan. Identify nearby driveways. Driveways spacing standards are contained in Lane Code 15.138. Copy of DLCD Final Order and Home Site Authorization Written statement addressing compliance with all Home Site Authorization terms included in the DLCD Final Order and Home Site Authorization Documentation of transfer of ownership if Property Owner is someone other than Claimant PROPERTY INFORMATION ZONING ACREAGE: ADJOINING OWNERSHIP Is any adjacent property under the same ownership as the subject property? List the map and tax lot(s). GENERAL ACCESS REQUIREMENTS Lane Code 15.135. All lots, parcels, or building sites shall have reasonably safe and usable vehicular access either directly to a Public Road, County Road, State Road or an approved Private Access Easement. The access to the homesite must past a two part test. First, the homesite must have legal access. Second, that access must be reasonably safe and useable. First: A lot or parcel shall be considered as having legal access for the purposes of development when the lot or parcel: (check the one that applies) (A) Was created in an approved and recorded land division; or (B) Is part of an unrecorded subdivision filed with the County as a survey recorded prior to January 1, 1955, and the roads in the unrecorded subdivision were dedicated to the County but may not have been accepted as Public Roads as defined in LC 15.010(35); or (C) Is adjacent to a Public Road or County Road, and meets the frontage requirements of LC 15.120; or (D) Is served by a Private Access Easement meeting the requirements of LC 15.055; or (E) Is adjacent to a state road and meets any applicable state access and permit requirements. M49 Forest Zone Dwelling Page 2 of 11

Second: A lot or parcel shall be considered as having reasonably safe and usable vehicular access for purposes of development if the road providing access to the lot or parcel is: (check the one that applies) (A) a County-maintained road or State-maintained road; or (B) a Public Road, Local Access Road, or Private Access Easement physically constructed and maintained to the requirements specified in this chapter; and any applicable dedication and improvement requirements of this chapter are met. EXISTING IMPROVEMENTS Does the property contain any roads, structures, etc.? NUMBER OF EXISTING DWELLINGS ON PARCEL: PHYSICAL FEATURES: Describe the site. Identify any steep slopes, water bodies (creeks, ponds, etc.) or other significant features. Include additional pages if necessary. SITING CRITERIA Lane Code 16.211(8) These standards are designed to make the proposed dwelling compatible with forest operations and agriculture, to minimize wildfire hazards and risks and to conserve values found on forest lands. The standards in LC 16.211(8)(a)-(b) below shall be weighed together with the requirements in LC 16.211(8)(c) and (e) below to identify the building site. (a) Setbacks. Residences, dwellings or manufactured dwellings and structures shall be sited as follows: (i) Near dwellings or manufactured dwellings on other tracts, near existing roads, on the most level part of the tract, on the least suitable portion of the tract for forest use and at least 30 feet away from any ravine, ridge or slope greater than 40 percent; On the site plan, identify: The most level part of the property. M49 Forest Zone Dwelling Page 3 of 11

The area that is least suitable for forest use based on the soil productivity, forest management and forest harvesting practices. Explain the reason for the proposed location. You must address the following issues: How close is the new dwelling to other dwellings on adjacent property? Will a new driveway need to be constructed? Will an existing driveway be extended? Is there a ravine, ridge or slope greater than 40% within 30 feet of the new dwelling? (ii) With minimal intrusion into forest areas undeveloped by non-forest uses; and Will the dwelling encroach into a forested area or be located in an existing open area? Explain: (iii) Where possible, when considering LC 16.211(8)(a)(i) and (ii) above and the dimensions and topography of the tract, at least 500 feet from the adjoining lines of property zoned F-1 and 100 and at least 30 feet from the adjoining lines of property zoned F-2 or EFU; and On the site plan, show the new dwelling and the property lines. Is the dwelling within 500 feet of adjoining property zoned F-1? Yes No If yes, explain: Is the dwelling within 130 feet of adjoining property zoned F-2 or EFU? Yes No If yes, explain: M49 Forest Zone Dwelling Page 4 of 11

(iv) Except for property located between the Eugene-Springfield Metropolitan Area General Plan Boundary and the Eugene and Springfield Urban Growth Boundaries, where setbacks are provided for in LC 16.253(6), the riparian setback area shall be the area between a line 100 feet above and parallel to the ordinary high water of a Class I stream designated for riparian vegetation protection in the Rural Comprehensive Plan. No structure other than a fence shall be located closer than 100 feet from ordinary high water of a Class I stream designated for riparian vegetation protection by the Rural Comprehensive Plan. A modification to the riparian setback standard for a structure may be allowed provided the requirements of LC 16.253(3) or LC 16.253(6), as applicable, are met; and Is there a water body on the property? Yes No If so, it must be indicated on the site plan. The dwelling must be at least 100 feet from the ordinary high water mark of a Class I stream. The location of the ordinary high water mark is determined by planning staff. A Riparian Declaration application is required if the dwelling is within 125 feet of the ordinary high water mark. You will be notified if a riparian declaration is required. (v) Structures other than a fence or sign shall not be located closer than: (aa) 20 feet from the right-of-way of a state road, County road or a local access public road specified in Lane Code LC Chapter 15; and (bb) 30 feet from all other property lines; and (cc) The minimum distance necessary to comply with LC 16.211(8)(a) above and LC 16.211(8)(b) through (d) below. The new dwelling must be at least 30 feet from any property line, and 20 feet from the right-ofway of a state road, County road or a local access public road. Some roads have additional setback requirements. Refer to Lane Code Chapter 15 for additional road setbacks. (b) The amount of forest lands used to site access roads, service corridors and structures shall be minimized. Explain how the location of the dwelling and driveway minimize intrusion into the forest. Attach additional pages if necessary. (c) Fire Siting Standards. The following fire-siting standards or their equivalent shall apply to new residences, dwellings, manufactured dwellings or structures: (i) Fuel-Free Breaks. The owners of dwellings, manufactured dwellings and structures shall maintain a primary safety zone surrounding all structures and clear and maintain a secondary fuel break on land surrounding the dwelling or manufactured dwelling that is owned or controlled by the owner in compliance with these requirements. (aa) Primary Safety Zone. The primary safety zone is a fire break extending a minimum of 30 feet in all directions around dwellings, manufactured dwellings and structures. The goal within the primary safety zone is to exclude fuels that will produce flame M49 Forest Zone Dwelling Page 5 of 11

lengths in excess of one foot. Vegetation within the primary safety zone could include green lawns and low shrubs (less than 24 inches in height). Trees shall be spaced with greater than 15 feet between the crown and pruned to remove dead and low (less than eight feet) branches. Accumulated leaves, needles, and other dead vegetation shall be removed from beneath trees. Nonflammable materials (i.e., rock) instead of flammable materials (i.e., bark mulch) shall be placed next to the house. As slope increases, the primary safety zone shall increase away from the house, parallel to the slope and down the slope, as shown in the table below: Size of the Primary Safety Zone by Percent Slope % Slope Feet of Primary Feet of Additional Safety Zone Safety Zone Down Slope 0 30 0 10 30 50 20 30 75 25 30 100 40 30 150 Dwellings or manufactured dwellings shall not be sited on a slope greater than 40 percent. What is the slope of the land within 30 feet of the dwelling? The new dwelling must be surrounded by a 30 primary safety zone. If the dwelling is on a slope, the safety zone will increase, as shown in the table. The safety zone must be established prior to submittal of a building permit. (bb) Secondary Fuel Break. The secondary fuel break is a fuel break extending a minimum of 100 feet in all directions around the primary safety zone. The goal of the secondary fuel break is to reduce fuels so that the overall intensity of any wildfire would be lessened and the likelihood of crown fires and crowning is reduced. Vegetation within the secondary fuel break shall be pruned and spaced so that fire will not spread between crowns of trees. Small trees and brush growing underneath larger trees shall be removed to prevent spread of fire up into the crowns of the larger trees. Dead fuels shall be removed. The secondary fuel break must be established an additional 100 feet from the primary safety zone, but only on property you own. This will be a condition of approval and must be verified by planning staff prior to submittal of a building permit. Once you have established the safety zone and the fuel break, submit the Request for Verification of Conditions. Planning staff will visit the site to verify the construction meets the standards of the code. Please contact staff at 682-3989 for details regarding fire break standards. (ii) Structural Fire Protection. The dwelling or manufactured dwelling shall be located upon a parcel within a fire protection district or shall be provided with residential fire protection as evidenced by a long term contract with a fire protection district (FPD) recorded in Lane County Deeds and Records. If the dwelling or manufactured dwelling are not within a FPD, the applicant shall provide evidence that the applicant has submitted a written request for a long term services contract with the nearest FPD and to be annexed into the FPD boundaries. If the FPD and the Planning Director determine that inclusion within a FPD or contracting for residential fire protection is impracticable, the Planning Director shall require as a condition M49 Forest Zone Dwelling Page 6 of 11

of approval for the dwelling or manufactured dwelling that the property owner implement and maintain a Fire Protection Plan as an alternative means for protecting the dwelling or manufactured dwelling from fire hazards, consistent with the following standards: Is the property within a fire district?(circle the answer) Yes No If yes, go to (iii) on the next page. Name of fire district: If the property is not within a fire district, you have two options (choose one): (A) Submit evidence of a long term services contract with the nearest fire district and request annexation into the fire district, or (B) Develop a Fire Protection Plan. If this option is chosen, the fire protection plan will be a condition of approval. It must comply with standards in (aa) - (dd). These standards must be verified by planning staff prior to submittal of a building permit application. (aa) Implementation and maintenance in perpetuity of a 100-foot wide primary safety zone surrounding the perimeter of the dwelling or manufactured dwelling structures in compliance with the standards in LC 16.211(c)(i)(aa) above; and (bb) An external, fire protection system as a component to the equivalent Fire Protection Plan to mitigate the threat to the dwelling and residential structures by a seasonal wildfire or the threat to the forest resource base from a fire originating on the parcel in compliance with the following standards: (A) Provide a minimum of two all-weather, one-inch valve, fire hydrants and two fire hose reels with sufficient length of fire suppression hose at each hydrant to reach around fifty percent of the exterior of the dwelling and residential accessory structures. The hose reels shall be installed between 50-75 feet from the structure foundations. The minimum fire hose interior diameter shall be one-inch; (B) Provide a fire nozzle with each fire hose with multiple settings to allow stream, spray and fog applications of water on the exterior of the structures and landscape; (C) Provide and annually maintain a water supply and pumping system connected to the fire hydrants in compliance with the following minimum requirements: a swimming pool, pond, lake or similar body of water that at all times contains a minimum of 4,000 gallons of water; or a stream that has a continuous year-round flow of at least one cubic foot per second; or a 1,500- gallon storage tank, e.g., concrete septic tank connected to an operating groundwater well for refilling; or a high-yield groundwater well with a minimum yield of 30 gallons per minute for one hour; and a pump system capable of maintaining 80 psi line pressure to the two fire hydrants. (cc) The property owner shall provide verification from the Water Resources Department that any permits or registrations required for water diversions have been obtained or that such permits or registrations are not required under state law for the use; and (dd) Road or driveway access to within 15 feet of the water supply shall be provided for pumping units. The road or driveway access shall accommodate the turnaround of fire M49 Forest Zone Dwelling Page 7 of 11

fighting equipment during the fire season. Permanent signs shall be posted along the access route to indicate the location of the emergency water source. (iii) Chimneys and Roofs. Dwellings, manufactured dwellings or structures with any chimneys shall have a spark arrestor on the chimneys. All habitable roofed structures shall be regulated by the State of Oregon Structural Specialty Code or the State of Oregon One and Two Family Specialty Code. Roofing for dwellings and manufactured dwellings shall be asphalt shingles in accordance with Section 903, slate shingles in accordance with Section 904, metal roofing in accordance with Section 905, tile, clay or concrete shingles in accordance with Section 907 and other approved roofing which is deemed to be equivalent to Class C rated roof covering. Wood shingles and shake roofs are not permitted. When 50 percent or more of the roof covering of any one or two family dwelling or manufactured dwelling is repaired or replaced in one year, the roof covering shall be made to comply with this section. These construction standards will be a condition of approval and will be verified by staff. (d) Domestic Water Supplies. Evidence shall be provided that the domestic water supply is from a source authorized in accordance with the Water Resources Department's administrative rules for the appropriation of ground water or surface water and not from a Class II stream as defined in the Forest Practices Rule, OAR Chapter 629. If the water supply is unavailable from public sources or sources located entirely on the property, then the applicant shall provide evidence that a legal easement has been obtained permitting domestic water lines to cross the properties of affected owners. For purposes of LC 16.211(8)(d) above, evidence of domestic water supply means: What is your water source (check the answer): Private Well Community System Public system Describe: (i) Verification from a water purveyor that the use described in the application will be served by the purveyor under the purveyor's rights to appropriate water; or For a community or public system, do you have written verification the provider can serve your dwelling? Yes No If yes, include a copy with this application. (ii) A water use permit issued by the Water Resources Department for the use described in the application; or (iii) Verification from the Water Resources Department that a water use permit is not required for the use described in the application. If the proposed water supply is from a well and is exempt from permitting requirements under ORS 537.545, the applicant shall submit the well constructor's report to the Department upon completion of the well. M49 Forest Zone Dwelling Page 8 of 11

Do you have a water use permit (well log) for an existing well, issued by the Water Resources Department? Yes No If yes, include a copy with this application. Copies can be obtained at the following website: oregon.gov/owrd/index.shtml (e) Fire Safety Design Standards for Roads and Driveways. Private driveways, roads or bridges accessing only commercial forest uses are not subject to compliance with these fire safety design standards for roads and driveways. The route of access for fire fighting equipment, from the fire station to the destination point, across public roads, bridges, private roads or private access easements and driveways shall comply with the standards specified below in LC 16.211(8)(e). Evidence of compliance with the standards specified in LC 16.211(8)(e) below should include objective information about the fire fighting equipment, the physical nature of the access route, the nature of any proposed improvements to the access route, and it may also include a written verification of compliance from the agency providing fire protection, or a written certification of compliance from an Oregon Registered Professional Engineer. As used herein, "road" means a way of access used for more than one use and accessory uses dwelling or manufactured dwelling. As used herein, "driveway" means a way of access used for only one dwelling or manufactured dwelling. (i) Road and Driveway Surfaces. Roads shall have unobstructed widths of at least 20 feet including: travel surfaces with widths of at least 16 feet constructed with gravel to a depth sufficient to provide access for fire fighting vehicles and containing gravel to a depth of at least six-inches or with paving having a crushed base equivalent to six inches of gravel, an unobstructed area two feet in width at right angles with each side of the constructed surface, curve radii of at least 50 feet, and a vertical clearance of at least 13 feet 6 inches. Driveways shall have: constructed widths of at least 12 feet with at least six inches of gravel or with paving having a crushed base equivalent to six inches of gravel and shall have a vertical clearance of 13 feet 6 inches. These construction standards will be a condition of approval and will be verified by staff. In addition, refer to the General Access Requirements on page 2 of this form. (ii) Turnarounds. Any dead-end road over 200 feet in length and not maintained by Lane County shall meet these standards for turnarounds. Dead-end roads shall have turnarounds spaced at intervals of not less than 500 feet. Turnarounds shall comply with these design and construction standards: (aa) Hammerhead Turnarounds. Hammerhead turnarounds (for emergency vehicles to drive into and back out of to reverse their direction on the road) shall intersect the road as near as possible at a 90 degree angle and extend from the road at that angle for a distance of at least 20 feet. They shall be constructed to the standards for driveways in LC 16.211(8)(e)(i) above and shall be marked and signed by the applicant as "NO PARKING." Such signs shall be of metal or wood construction with minimum dimensions of 12 inches by 12 inches; or (bb) Cul-de-sac Turnarounds. Cul-de-sac turnarounds shall have a right-of-way width with a radius of at least 45 feet and an improved surface with a width of at least 36 feet and shall be marked and signed by the applicant as "NO PARKING." Such signs shall be of metal or wood construction with minimum dimensions of 12 inches by 12 inches; and (cc) No cul-de-sacs or hammerhead turnarounds shall be allowed to cross any slope which will allow chimney-effect draws unless the dangerous effects of the chimneyeffect draws have been mitigated by the location of the road and, where necessary, by the creation of permanent fire breaks around the road. M49 Forest Zone Dwelling Page 9 of 11

Are you proposing a dead-end road? Yes No Is it over 200 feet long? Yes No If yes, it must contain turnouts. Explain: (iii) Bridges and Culverts. Bridges and culverts shall be constructed to sustain a minimum gross vehicle weight of 50,000 lbs. and to maintain a minimum 16-foot road width surface or a minimum 12-foot driveway surface. The Planning Director may allow a single-span bridge utilizing a converted railroad flatcar as an alternative to the road and driveway surface width requirements, subject to verification from a engineer licensed in the State of Oregon that the structure will comply with the minimum gross weight standard of 50,000 lbs. Will the driveway or road contain any culverts or bridges? Yes No If yes, explain: (iv) Road and Driveway Grades. Road and driveway grades shall not exceed 16 percent except for short distances when topographic conditions make lesser grades impractical. In such instances, grades up to 20 percent may be allowed for spans not to exceed 100 feet. An applicant must submit information from a Fire Protection District or engineer licensed in the State of Oregon demonstrating that road and driveway grades in excess of eight percent are adequate for the fire fighting equipment of the agency providing fire protection to access the use, fire fighting equipment and water supply. Will the road or driveway contain any slopes in excess of 8% or 16%? Yes No If yes, explain: (v) Identification. Roads shall be named and addressed in compliance with LC 15.305 through 15.335. Will the road provide access to more than three dwellings? Yes No If yes, the road must be named. This will be a condition of approval and a road name application will be included with the packet that is sent to you. (vi) Driveway Vehicle Passage Turnouts. Driveways in excess of 200 feet shall provide for a 20- foot long and eight-foot wide passage space (turn out) with six inches in depth of gravel and at a maximum spacing of 400 feet. Shorter or longer intervals between turnouts may be authorized by the Planning Director where the Director inspects the road and determines that topography, vegetation, corners or turns obstruct visibility. M49 Forest Zone Dwelling Page 10 of 11

The driveway must be 12 feet wide. How wide is the driveway? Is it over 200 feet long? Yes No If yes, it must contain turnouts. Turnouts are not required if the driveway is 16 feet wide. Will the driveway have turnouts? Yes No Will the driveway be 16 feet wide? Yes No (vii) Modifications and Alternatives. The standards in LC 16.211(8)(e)(i) through (vi) above may be modified by the Approval Authority provided the applicant has submitted objective evidence demonstrating that an alternative standard would insure adequate access for fire fighting equipment from its point of origination to its point of destination. Are you proposing any modifications or alternatives to the road or driveway standards? If yes, explain. Attach additional pages of necessary. M49 Forest Zone Dwelling Page 11 of 11